Tick paralysis also known as Tick bite paralysis is a neuromuscular condition that causes ascending symmetric flaccid paralysis.

Clinical features:

• Prodrome phase followed by weakness
• Then acute generalised weakness (ascending symmetric flaccid paralysis), involves cranial nerves, usually occurs in children, usually spring or summer.
• No sensory symptoms
• +Tick bite or tick attached to skin
• In Australia: Ixodes holocyclus female tick bite, usually behind the ear or on the scalp.
• In North America: Dermacentor andersoni or D. variabilis

Findings on Investigations:

Nerve conduction studies/electromyography (NCS/EMG):

• CMAP: Low amplitude
• Motor Conduction velocity: normal or subtle abnormalities
• Sensory conduction velocity & sensory action potentials: normal or subtle abnormalities
• EMG: Repetitive stimulation: normal

Treatment:

• Removal of the tick from the skin